Review of Navigation Team 2018 Quarter 2 Report February 7, 2019 (Exhibit 5 revised February 12, 2019) David G. Jones, City Auditor Seattle Office of City Auditor Review of Navigation Team 2018 Quarter 2 Report Report Highlights This report, requested by Seattle City Councilmember Lisa Herbold, is part of a series of reports intended to promote continuous improvement in the City of Seattle’s Navigation Team approach. Specifically, this report assesses four reporting checkpoints from the Executive’s Quarter 2 response to the Navigation Team reporting plan, a plan with 14 reporting checkpoints AUDIT SCOPE This audit addresses 4 of the 14 reporting checkpoints in the Navigation Team reporting plan: 2.1 designed to help inform the City Council on the Navigation Team approach. 2.2 The Navigation Team is an approach developed by former Mayor Murray’s administration. When the City launched the Navigation Team in February 2017, its stated goal was “to provide outreach to people living unsheltered that is efficient and effective at moving people out of hazardous conditions and onto a path toward health, stability, and permanent housing.” 1 Drafts of this report were reviewed by the Executive, and this version incorporates its input. What We Found We identified findings for four of the reporting checkpoints in the Executive’s Quarter 2 response to the Navigation Team reporting plan. Significant findings include: • Providing outreach to newly unsheltered individuals is a gap in the City’s current approach that could be informed by practices in other jurisdictions. • The City does not currently use a robust systematic approach for managing homeless outreach field operations, which involve nine nonprofit organizations, multiple City agencies, and King County. • Outreach providers, including the Navigation Team, need direct access to diversion resources to better serve newly unsheltered individuals, and the Human Service’s Department’s December 2018 diversion guidelines represent a significant positive step. • Gaps exist in prioritizing hygiene for unsheltered individuals: only six City-funded restrooms are available 24 hours x 7 days, and drop-in showers have gaps in geographic coverage and hours of operation. • Opportunities to use hygiene as a gateway to other services could be informed by practices in other jurisdictions. • The Executive does not currently have plans for rigorous independent evaluation of the Navigation Team approach. 1 See Navigation Team reporting plan, Appendix B. 3.5 3.6 Assessment of opportunities for early outreach intervention Assessment of opportunities for prioritizing hygiene Development of a stronger evaluation plan Plan for unsheltered individuals to be meaningfully involved in Navigation Team evaluation PREVIOUS REPORTS ON NAVIGATION TEAM Our two previous reports in this series are: • Reporting Plan for Navigation Team, November 2017 • Review of Navigation Team Quarter 1 Report, October 2018 AUDIT RECOMMENDATIONS Based on our audit findings, we developed a set of 13 recommendations that are listed in Appendix B of this report. Our office will report on the status of these recommendations through our annual recommendation follow-up process. Seattle Office of City Auditor David G. Jones, City Auditor www.seattle.gov/cityauditor Review of Navigation Team 2018 Quarter 2 Report TABLE OF CONTENTS INTRODUCTION ............................................................................................................................................. 1 CHECKPOINT 2.1: ASSESSMENT OF OPPORTUNITIES FOR EARLY OUTREACH INTERVENTION ........... 4 CHECKPOINT 2.2: ASSESSMENT OF OPPORTUNITIES FOR PRIORITIZING HYGIENE ............................ 18 CHECKPOINT 3.5: DEVELOPMENT OF A STRONGER EVALUATION PLAN AND .................................... 32 CHECKPOINT 3.6: PLAN FOR UNSHELTERED INDIVIDUALS TO BE MEANINGFULLY ENGAGED IN THE NAVIGATION TEAM EVALUATION............................................................................................................. 32 OBJECTIVES, SCOPE, AND METHODOLOGY .............................................................................................. 35 APPENDIX A ................................................................................................................................................. 37 References and Hyperlinks .......................................................................................................................................................... 37 APPENDIX B ................................................................................................................................................. 41 List of Recommendations ............................................................................................................................................................ 41 APPENDIX C ................................................................................................................................................. 43 Staffing Detail for HSD’s Contracted Outreach and Engagement Providers ........................................................... 43 APPENDIX D ................................................................................................................................................. 45 Drop-In Showers ............................................................................................................................................................................. 45 APPENDIX E .................................................................................................................................................. 48 Letter from the Public Defender Association ....................................................................................................................... 48 APPENDIX F .................................................................................................................................................. 50 Seattle Office of City Auditor Mission, Background, and Quality Assurance ........................................................... 50 Review of Navigation Team 2018 Quarter 2 Report INTRODUCTION Audit Scope Our office produced this report at the request of Seattle City Councilmember Lisa Herbold. This report is part of an ongoing effort to promote continuous improvement in the City’s Navigation Team approach to addressing unsheltered homelessness. Specifically, this report assesses four reporting checkpoints from the Executive’s Quarter 2 response to the Navigation Team reporting plan: Exhibit 1: Four Reporting Checkpoints Addressed in the Executive’s 2018 Quarter 2 Report Checkpoint # 2.1 2.2 3.5 3.6 Request Assessment of opportunities for early outreach intervention Assessment of opportunities for prioritizing hygiene Development of a stronger evaluation plan Plan for unsheltered individuals to be meaningfully involved in Navigation Team evaluation In December 2018, the Mayor and the County Executive announced plans for developing a new regional approach to addressing homelessness and released a consultant report that outlined ten action areas. We believe that the findings and recommendations in our report are consistent with the themes presented in the recent consultant report. Further, the City’s attention to our report recommendations and its efforts toward continuous improvement related to the Navigation Team will more effectively position the City for successful participation in a future regional approach. Page 1 Review of Navigation Team 2018 Quarter 2 Report Background On January 26, 2018, a point in time count found that, in Seattle, 4,488 people were unsheltered (i.e., they were sleeping in tents, vehicles and RVs, and on the street). Exhibit 2: Locations of Unsheltered Individuals in Seattle, January 2018 Unsheltered Individuals = 4,488 total On Streets/Outside (no tent) 1,120 Tents 1,034 Abandoned Buildings 55 RVs 1,375 Cars & Vans 904 Source: Office of City Auditor analysis of data from the Seattle/King County Point in Time Count for Persons Experiencing Homelessness, 2018 The Navigation Team is an approach developed by former Mayor Murray’s administration for addressing the issue of people living unsheltered in Seattle. The Navigation Team became operational in February 2017. The team is “comprised of specially-trained Seattle Police Department (SPD) officers, a supervising police sergeant, an outreach coordinator, an encampment response manager, field coordinators, and contracted outreach providers.” 2 The goal of the Navigation Team is “to provide outreach to people living unsheltered that is efficient and effective at moving people out of hazardous conditions and onto a path toward health, stability, and permanent housing.” 3 The Navigation Team Theory of Change (see below for our description of the Theory of Change approach) specifies that “the City has made the strategic operational decision to deploy the Navigation Team in conjunction with the ongoing encampment cleanup work conducted by the Finance and Administrative Services (FAS) Department.” 4 It is important for the City to ensure that the Navigation Team is an approach that is appropriate and humane as well as efficient and effective. 2 See Appendix B: Navigation Team Theory of Change. ibid 4 ibid 3 Page 2 Review of Navigation Team 2018 Quarter 2 Report This report assesses the Executive’s Quarter 2 response to the Navigation Team reporting plan, a plan with 14 reporting checkpoints designed to help inform the City Council about the Navigation Team approach. We proposed the reporting plan in our first report on the Navigation Team, which was published in November 2017. 5 Our second report on the Navigation Team was published in October 2018, and it assesses the Executive’s response to 7 of the 14 reporting checkpoints. The sections that follow address four of the reporting checkpoints in the Executive’s Quarter 2 response to the Navigation Team reporting plan (see Exhibit 1). We will address reporting checkpoint 2.3, Assessment of Strategies to Prevent Trash Accumulation, in a future report. All the metrics in this report, including staffing levels, budget, and outcomes are for 2018, unless otherwise noted. Exhibit 3: Reporting Checkpoints Addressed in the Executive’s 2018 Quarter 2 Report Checkpoint # 2.1 2.2 2.3* 3.5 3.6 Request Assessment of opportunities for early outreach intervention Assessment of opportunities for prioritizing hygiene Assessment of strategies to prevent trash accumulation Development of a stronger evaluation plan Plan for unsheltered individuals to be meaningfully involved in Navigation Team evaluation *This reporting checkpoint will be addressed in a future report. Source: Executive’s Quarter 2 response to the Navigation Team reporting plan 5 Reporting Plan for Navigation Team, November 2017, Seattle Office of City Auditor. Page 3 Review of Navigation Team 2018 Quarter 2 Report CHECKPOINT 2.1: ASSESSMENT OF OPPORTUNITIES FOR EARLY OUTREACH INTERVENTION “While we had a collection of providers that were operating successfully and independently, none of those providers could themselves solve homelessness, and we needed to think of ourselves as a complete system. Each of those providers had to be working in tandem to achieve a particular result.” – Mandy Chapman Semple describing Houston’s approach to addressing homelessness at Seattle Townhall, March 2017 Section Summary Reporting Checkpoint 2.1 asked the Executive to provide an assessment of the City’s ability to provide early outreach intervention to newly unsheltered individuals before they become chronically unsheltered. This request was based, in part, on examples from other jurisdictions, including New York and London. The Executive’s Quarter 2 Response acknowledged that providing outreach to newly unsheltered individuals is a gap in the City’s current approach. The Executive indicated that the Navigation Team “often encounters those who are in the initial stages of their homelessness,” but has “current challenges in appropriately addressing the needs of these ‘newly homeless’ individuals.” The Executive indicated that the challenges with serving those newly unsheltered included: 1) “inconsistency in collecting and tracking data related to length of time homeless,” and 2) “lack of access to funding to rapidly rehouse those who are newly homeless.” The City’s Navigation Team currently “engages primarily with individuals who have lived in unsanctioned encampments for an extended period of time.” However, the Navigation Team is only one component of the City’s approach to homeless outreach. In addition to the Navigation Team, the Human Services Department (HSD) currently funds six additional organizations that also provide street-based homeless outreach in the field. The City also provides funding for a Seattle Mobile Medical Van, operated by Public Health - Seattle & King County, and increasingly, the Seattle Police Department (SPD) has been using its Community Police Teams (CPTs) in each precinct to augment the work of the Navigation Team by working Navigation Team-designated “emphasis zones.” Page 4 Review of Navigation Team 2018 Quarter 2 Report Our findings suggest that the City could improve its outreach and service to those who are newly unsheltered by approaching outreach as a complete system. We recommend that the City consider improvements in the following areas: • better coordination among outreach providers • a robust, proven system for managing field operations • a central dispatch function for outreach • direct access for outreach providers to diversion resources By reaching and serving those who are newly unsheltered before they have “lived in an unsanctioned encampment for an extended period of time,” the City could ultimately expect to see a decrease in the need for Navigation Team interventions. Better coordination among homeless outreach providers is needed to improve the City’s ability to serve newly unsheltered individuals Homeless outreach has become a significant ongoing field operation in Seattle. However, City-funded homeless outreach is decentralized, and there is no system for frequent tactical communication among all homeless outreach providers. Unlike the approach recommended above by Houston’s Mandy Chapman Semple, 6 the City of Seattle is not currently thinking of homeless outreach “as a complete system.” This lack of coordination limits the City’s ability to provide proactive outreach to newly unsheltered individuals before they become chronically unsheltered. On any given day that the City’s Navigation Team is working in the field, there are six 7 additional HSD-funded organizations 8 also providing street-based homeless outreach in the field. The City also provides funding for a Seattle Mobile Medical Van, operated by Public Health Seattle & King County, which served 753 homeless individuals living on the streets of Seattle in 2017. In addition, Seattle Public Utilities (SPU) funds a team of three staff (including one nurse) from the Hepatitis Education Project to provide weekly outreach and trash bag deliveries to the SPU encampment trash pilot sites. Increasingly, SPD has been using its Community Police Teams (CPTs) in each precinct to complement the work of the Navigation Team by working in Navigation Team-designated “emphasis zones.” SPD’s Assistant Chief of Collaborative Policing indicated that CPT officers are currently spending between 60-80% of their time addressing issues related to unsheltered homelessness. SPD indicated that the CPT officers’ “interactions with unsheltered individuals consist of counting 6 Mandy Chapman Semple served as Special Assistant to the Houston Mayor for Homeless Initiatives from 2013-16. See Exhibit 4 – The Navigation Team includes an HSD contract with ETS-REACH for outreach services. In addition, HSD has outreach contracts with Seattle Indian Center, Mary’s Place, Seattle Indian Health Board, DESC-HOST, YouthCare, and Urban League. Further, HSD has a contract with the Public Defender Association-LEAD to provide outreach case management for LEAD referrals. 8 See Appendix C for the staffing detail for HSD’s contracted Outreach and Engagement providers. 7 Page 5 Review of Navigation Team 2018 Quarter 2 Report tents and campers during the course of premise checks, asking any individuals they talk to if they want to meet with outreach staff, and reporting emphasis zone conditions and requests for contact to the Navigation Team.” Exhibit 4 depicts the City’s 2018 reporting structure for these field operations. 9 As depicted, the reporting structure is decentralized, with City staff and contracted providers reporting through multiple layers of City staff across three departments. 9 Exhibit 4 is a partial picture of Seattle’s field operations. It attempts to depict the City staff and contracted providers who are explicitly working with unsheltered individuals in the field. The Executive indicated that Exhibit 4 does not include City staff who are increasingly in contact with unsheltered individuals while performing their duties including staff from the Fire Department, Department of Parks and Recreation, Seattle Public Libraries, etc. Page 6 Review of Navigation Team 2018 Quarter 2 Report Exhibit 4: Field Staff – Unsheltered Homeless Engagement – Reporting Structure as of January 2019 See Appendix C for the staffing detail for HSD’s Contracted Outreach and Engagement Providers Source: Office of City Auditor analysis of HSD contracts and information provided by SPD and SPU 1 Per SPD, the total number of Navigation Team Officers will increase from 10 to 11 in early 2019. Page 7 Review of Navigation Team 2018 Quarter 2 Report In addition to the staff and organizations depicted in Exhibit 4, we identified six additional organizations that provide homeless outreach in Seattle without City funds (See Exhibit 5). Consequently, the daily number of field staff engaging with unsheltered individuals on the street in Seattle in addition to the Navigation Team could easily be more than 50 on any given day. This number does not include volunteers (e.g., Seattle’s Union Gospel Mission works with volunteers to conduct Search and Rescue visits to unsheltered individuals 365 days per year). Regular systematic coordination is primarily limited to the Navigation Team and City departments. The City does not currently have a system for regular systematic coordination and communication that also includes the providers funded by HSD and SPU, the Seattle Mobile Medical Van, and the SPD Community Police Teams. The Navigation Team itself holds a daily meeting at 7:30 am (MondayThursday) with its staff from HSD, SPD, and the outreach contractor, ETS-REACH. In addition, the Navigation Team convenes a weekly 30minute check-in meeting with its City department partners, including HSD, SPD, and the outreach contractor, ETS-REACH as well as other departments, such as SPU, Parks, and the Seattle Department of Transportation (SDOT). Late in 2018, in addition to ETS-REACH, several outreach providers began attending the Navigation Team morning meeting on at least a weekly basis. This includes several City-funded outreach providers, including the Downtown Emergency Services Center (DESC) and Mary’s Place, as well as several non-City-funded providers, including MID Outreach and Full Life Care. However, the City does not have a consistent coordinated system for daily or weekly communication with all its street-based homeless outreach providers. HSD’s contracts with the agencies providing homeless outreach include a clause that requires coordination with the Navigation Team, 10 and HSD convenes periodic meetings that include representatives from the Navigation Team, City-funded outreach providers, and non-City funded outreach providers. However, these meetings focus on broad topics, such as coordinated entry and racial justice and are not a substitute for the frequent systematic tactical communication that is essential for successful field operations. Moreover, HSD attendance records indicate that the 10 The current HSD contract language for the outreach providers reads, “The program will also link to the other City of Seattle funded outreach programs to participate in coordination activities to ensure maximization of resources, seamless care, standards of practice, and geographic coverage. This coordination will include, but is not limited to, required attendance at outreach provider meetings and designated staff participation in the Navigation Team model as determined to be population appropriate.” Page 8 Review of Navigation Team 2018 Quarter 2 Report meetings have not been consistently attended by the City-funded outreach providers. Therefore, we recommend that the City consider implementing frequent systematic tactical communication among homeless outreach providers to improve coordination of the work. This might include better coordination of the street-based homeless outreach to address emerging geographic and/or demographic trends. It could also include tasking a subset of City-funded outreach staff to focus on proactive early intervention to individuals who are newly homeless. This improved coordination could help respond to the gap in service to newly homeless individuals acknowledged in the Executive’s Quarter 2 response. Page 9 Review of Navigation Team 2018 Quarter 2 Report Exhibit 5: Outreach Providers in Seattle Source: Office of City Auditor analysis of 2018 HSD Outreach and Engagement contracts * See the HSD 2018 Outreach and Engagement contract for LEAD, and see Appendix E for a letter from the Public Defender Association. Page 10 Review of Navigation Team 2018 Quarter 2 Report Effective management of field operations for agencies providing homeless outreach requires a robust, proven, systematic approach The City does not currently use a robust systematic approach for managing homeless outreach field operations, which involve nine nonprofit organizations, multiple City agencies, and King County. Without such an approach, the City cannot ensure outreach work is well-coordinated and effective. We encourage the City to consider reinstating some of the strategic coordination components from the Federal Emergency Management Agency’s (FEMA, Incident Command System (ICS)). When the Navigation Team was initiated in 2017, its first 37 weeks of operations were conducted as a formal activation at the City’s Emergency Operations Center (EOC). During this time, the City used elements of FEMA’s standardized strategic coordination approach called, Incident Command System (ICS). Over time, the City discontinued its use of ICS elements for ongoing coordination. However, reinstating some of the ICS elements could improve coordination among the numerous homeless outreach providers. Navigation Team during its EOC activation in 2017. Photo credit: City of Seattle EOC. Supported by FEMA’s Emergency Management Institute, ICS has become “the standard for emergency management across the country.” 11 Some of the elements of the ICS strategic framework include: • Unified Command – which allows agencies with different legal, geographic, and functional authorities and responsibilities to work together effectively without affecting individual agency authority, responsibility, or accountability; • Incident Action Planning – which provide a coherent means of communicating the overall objectives (i.e., “missions”) for both operational and support activities; 11 See ICS overview. Page 11 Review of Navigation Team 2018 Quarter 2 Report • Information and Intelligence Management – a process for gathering, analyzing, sharing, and managing incident-related information and intelligence; and • Dispatch/Deployment – a coordinated system for dispatch and deployment of personnel and equipment by an appropriate authority. Two jurisdictions, San Francisco and Snohomish County, are currently using the ICS framework for ongoing field operations. San Francisco activated its Healthy Streets Operation Center (HSOC) in January 2018. The San Francisco HSOC operates seven days a week to “provide unified and coordinated city services and responses to unsheltered persons experiencing homelessness.” HSOC triages calls/reports that come in through their 311 system and dispatches the calls to one or more agencies based on established criteria. Also, in the fall of 2017, Snohomish County began using the ICS framework to organize the work of multiple agencies and organizations in their response to the opioid epidemic. Snohomish County’s consolidated action plan provides clear assignments and accountability for tasks. Conversely, the City of Seattle discontinued use of the ICS framework when the EOC activation ended in 2017. The City had established nine missions during its EOC activation (see below). These nine original missions used during the City’s EOC activation were closed in 2017. Exhibit 6: Emergency Operations Center (EOC) Missions (closed in 2017) Source: City of Seattle EOC Page 12 Review of Navigation Team 2018 Quarter 2 Report HSD indicated that these “Missions” were all closed in late 2017, and the City discontinued 12 its use of their weekly consolidated action plan for tracking assignments 13 for each Mission area in April 2017. Further, currently, as depicted in Exhibit 4, there is a decentralized structure rather than a unified command structure for homeless outreach. Based on the size and the importance of the City’s investment in homeless outreach, we recommend that the City consider reinstating elements of the ICS framework to help ensure effective management of homeless outreach field operations. A coordinated mechanism for receiving reports of newly unsheltered individuals and dispatching outreach is needed The City does not have a coordinated mechanism for receiving reports of newly unsheltered individuals and quickly dispatching outreach workers to offer services. The current system for receiving requests is decentralized, and the Navigation Team is only dispatched to sites that are determined to be “hazardous” or “problematic.” Several other jurisdictions, including New York, London, and Los Angeles, have systems for reporting and dispatching outreach staff to the newly unsheltered. We recommend that the City consider improving its capacity for receiving reports of newly unsheltered individuals and quickly dispatching outreach. Our November 2017 report presented examples of other jurisdictions that provide outreach to newly unsheltered individuals, including: • London’s No Second Night Out program that exclusively serves individuals who find themselves sleeping on the streets (i.e., ‘rough sleepers’) for the first time. It includes a 7-day/24-hour assessment center and rapid offers of alternatives to sleeping unsheltered. From April 2011 to March 2018, 75 percent of all new rough sleepers who accessed No Second Night Out exited street homelessness and did not spend a second night sleeping unsheltered; and • New York City’s homeless outreach proactive weekly canvassing of every block in Manhattan, plus hot spots in other boroughs, to immediately identify people in need of services before they become chronically unsheltered. 12 SPU indicated that while the City, as a whole, discontinued its use of weekly consolidated action plans for tracking assignments in April 2017, SPU continues to track and manage its trash reduction work via the mission model. 13 The Navigation Team’s current system for tracking its work includes a log of “site journals” for activities at each physical location that the Navigation Team addresses as well as a “by-name list” that tracks Navigation Team clients. Page 13 Review of Navigation Team 2018 Quarter 2 Report In addition, in 2018 the Los Angeles Homeless Services Authority (LAHSA) launched LA-HOP, an online portal that anyone with access to a computer or mobile device can use to make a request to dispatch a homeless outreach team to the area. Click on the image above to see a video describing the LA-HOP homeless outreach portal. Photo/video used with permission of LAHSA. Currently the Navigation Team is the only City-funded homeless outreach that uses information from requests received by the City for homeless services. The City’s current system for receiving requests for services is decentralized; requests may come in through: • Find-It Fix-It App and Customer Service Bureau (CSB) – there are no selections for homeless services on the CSB tools; so CSB staff currently search the CSB requests for various keywords, such as camp, camper, or unsheltered persons, and create a daily Excel file for the Navigation Team to prioritize. • Direct requests to the Navigation Team SPD Sergeant – some businesses, organizations, and individuals contact the Navigation Team Sergeant directly; these requests are recorded on a paper pad, and photographs of the notes are texted to the Navigation Team. • Direct requests to SPD Precincts – some businesses, organizations, and individuals contact the individual SPD Precincts directly; these requests may be forwarded to the Navigation Sergeant. We also learned that some requests are dispatched to the Precinct’s Community Police Team (CPT) at the discretion of the Precinct Captain. Further, the Navigation Team is dispatched only to sites that are determined to be “hazardous” or “problematic” based on a set of criteria, so newly unsheltered individuals would only be served by the Navigation Team if they were found at these sites. The Executive’s Quarter 2 Response acknowledged that providing outreach to newly unsheltered individuals is a gap in the City’s current approach. The Executive indicated that the Navigation Team “often encounters those who are in the initial stages of their homelessness,” but has “current challenges in appropriately addressing the needs of these ‘newly homeless’ individuals.” The City may wish to consider examples from other jurisdictions, including New York, London, and Los Angeles, that have systems for reporting and dispatching outreach staff to the newly unsheltered. Page 14 Review of Navigation Team 2018 Quarter 2 Report England and Wales have a national reporting system called StreetLink that dispatches homeless outreach workers in local jurisdictions, including London’s No Second Night Out program. People who report through StreetLink receive an update on what has happened as a result of their alert within 10 working days. New York’s HOME-STAT program receives requests for homeless outreach through its 311 system and dispatches contracted outreach workers within an average of one hour. Los Angeles’ new portal, LA-HOP receives online requests for homeless outreach throughout the county and, according to their website, “deploys the most appropriate outreach team, with the goal of reducing response times to those in need.” Late in 2018, inspired by LA-HOP. A Seattle homeless services provider, Mary’s Place, developed its own homeless outreach portal. This demonstrates great initiative by Mary’s Place, and demonstrates that Seattle outreach providers are interested in a mechanism for receiving reports about newly unsheltered individuals and dispatching outreach. However, LA-HOP and the examples from New York and London described above are coordinated by a central authority, include multiple outreach providers, and cover an entire city or region. The City of Seattle might consider working with the Navigation Team partners and outreach providers to develop a centralized portal. Outreach providers, including the Navigation Team, need direct access to diversion resources to better serve newly unsheltered individuals Diversion strategies allow unsheltered individuals to bypass the shelter system altogether by reunifying them with a family or friend support network, providing mediation to resolve an issue with a roommate or landlord, providing first and last month rent, or providing other assistance that keeps the individuals from becoming unsheltered. If City homeless outreach providers, including the Navigation Team, had direct access to diversion resources, they could more effectively serve newly unsheltered individuals. In December 2018, the City of Seattle, All Home, Building Changes, King County and the United Way released new guidelines for diversion services, which will be reflected in the 2019 HSD contracts with homeless services providers. These new guidelines include a performance standard for contacted outreach providers that 20% of enrolled clients will be from the homeless crisis response system each quarter. It is not clear if this standard will also apply to the City’s Navigation Team. Our October 2018 report found that none of the City’s eight diversion contracts mentioned coordination with the Navigation Team or Page 15 Review of Navigation Team 2018 Quarter 2 Report prioritization of Navigation Team clients for diversion resources. 14 We have previously recommended that the City consider increasing use of diversion strategies (e.g., reunification with family/friends) for Navigation Team clients. Diversion strategies could also be used to serve newly unsheltered individuals. Therefore, we recommend that the City consider increasing access to and use of diversion strategies for all City-funded homeless outreach (i.e., Navigation Team and other Cityfunded homeless outreach providers) to serve newly unsheltered individuals. The December 2018 diversion guidelines represent a significant positive step to ensure more effective use of the City’s diversion resources. Some other jurisdictions have successfully used diversion strategies for newly unsheltered individuals. For example, London’s No Second Night Out program is essentially a diversion program that rapidly identifies newly unsheltered individuals, provides 24x7 assessment of their situations, and quickly works with clients on alternatives to sleeping on the streets. No Second Night Out has staging facilities where clients can stay while staff work out legal issues, secure identification (if lost), or explore reunification options. In addition, our October 2018 report described the Downtown San Diego Partnership, whose clients included newly unsheltered individuals. Between June 26, 2017 and May 1, 2018, the Downtown San Diego Partnership reunited 696 homeless individuals with support systems across the country at a total cost of $343,128. 14 In addition, the diversion contracts provide very little guidance to provider organizations on who should receive City diversion resources. For example, only one of the contracts specifies that participant eligibility for diversion services is intended for homeless individuals in Seattle. The other seven contracts do not specify that participants must be homeless in Seattle. This current contractual structure means the City might be missing opportunities to direct diversion dollars to those living on Seattle streets, including Navigation Team clients. For example, one HSD-funded diversion provider indicated that their clients may come from as far away as Sequim for diversion services. Page 16 Review of Navigation Team 2018 Quarter 2 Report Recommendations The table below lists our recommendations for Checkpoint 2.1: Assessment of opportunities for early outreach intervention. Checkpoint # 2.1 Assessment of opportunities for early outreach intervention Recommendation A. The City should consider implementing frequent systematic tactical communication among outreach providers. B. The City should use a robust systematic approach for managing homeless outreach field operations and should consider reinstating elements of the ICS framework to help ensure effective management of homeless outreach field operations. C. The City should consider improving its capacity for receiving reports of newly unsheltered individuals and quickly dispatching outreach. D. The City should consider increasing access to and use of diversion strategies for all City-funded homeless outreach (i.e., Navigation Team and other City-funded homeless outreach providers) to serve newly unsheltered individuals. E. The Executive should provide the Office of City Auditor with a status report on the implementation of the planned “enhancements” described in the Quarter 2 response: a. Enhance data collection practices to create a history and duration of homelessness for all individuals encountered in the field. b. Increase opportunities for shared resources such as diversion and rapid re-housing assistance to increase resources and the speed with which people are transitioned to more stable housing options. c. Increase skills and training for outreach staff to provide robust and trauma-informed mental health and substance use disorder services. d. Increase partnerships with community-based organizations that provide employment training, education and culturally-based support services to improve client outcomes for housing retention. e. Increase skillset of the Navigation team to include stronger relationships with individuals with lived experience as peer supports. Page 17 Review of Navigation Team 2018 Quarter 2 Report CHECKPOINT 2.2: ASSESSMENT OF OPPORTUNITIES FOR PRIORITIZING HYGIENE “Something that is clear to the Special Rapporteur every time she visits residents living in appalling conditions in informal settlements in the midst of or on the margins of thriving cities where commercial and luxury residential developments abound…is that by any measure — moral, political or legal — it is unacceptable for people to be forced to live this way. Refusing to accept the unacceptable is where we must begin.” –Special Rapporteur to the United Nations (U.N.) General Assembly from Report of the Special Rapporteur on adequate housing as a component of the right to an adequate standard of living, and on the right to nondiscrimination in this context, September 19, 2018 Section Summary Reporting Checkpoint 2.2 recommended that the Executive consider options for prioritizing access to hygiene for unsheltered individuals to reduce the risk of sites experiencing environmental hazards and communicable disease outbreak. The Executive’s Quarter 2 Response provided a list of 2018 City-funded sites where people experiencing homelessness can access hygiene services and described recent efforts taken by HSD and Public Health Seattle & King County to prevent transmission of Hepatitis A. Increasing access to enhanced shelters would prioritize hygiene and could reduce environmental and public health risks. Our November 2017 report and our October 2018 report provided examples from other jurisdictions that have quickly increased the number of enhanced shelters. 15 In addition to recommending that the City to consider ways to quickly and significantly increase enhanced shelter capacity, we identified additional steps that the City could take to improve the provision of hygiene services, including: 1. Increase availability of 24x7 restrooms; 2. Ensure that there is adequate geographic coverage and hours of operation for drop-in shower facilities; 3. Leverage hygiene services as an opportunity to provide outreach and other services; and 15 Enhanced shelters provide access to drinking water, heat and electricity, showers, laundry, safe cooking facilities, storage for belongings, and accommodate couples and pets. We noted in our October 2018 report that several jurisdictions received private funding to defray the start-up costs for the enhanced shelters. Page 18 Review of Navigation Team 2018 Quarter 2 Report 4. Ensure that there is consistent messaging, signage, and standard of care in drop-in hygiene facilities. Increasing enhanced shelter capacity is a humane approach to addressing public health risks Between July and December 2018, we conducted several field visits 16 and observed public health and safety risks, including those described in Exhibit 7. Exhibit 7: The Office of City Auditor Observed Public Health and Safety Risks Public Health and Safety Risk Fire hazards Office of City Auditor Observations • • • • Individuals cooking on a camping stove inside a small tent Open flame cooking in metal buckets and trash bins Generators under plastic tarps Corrosive materials near tents and vehicles Environmental hazards • Uncovered buckets of human waste left to be picked up by SPU contractors at various encampment trash pilot locations • Exposed used needles in plastic bags left to be picked up by SPU contractors at various encampment trash pilot locations • An embankment at Dr. Jose Rizal Park that serves as a latrine, with discarded syringe parts thickly scattered along the path to the embankment • Feces on the sidewalk in Lake City Mini Park and on the streets and sidewalks at various encampment trash pilot locations • Presence of rats 17 Health risks • Numerous individuals living in tents without nearby access to a restroom, including a veteran in a wheelchair • Unrefrigerated storage of perishable food in and around various encampment trash pilot locations • A woman living in a tent who indicated that she does not drink water, so she does not have to urinate 16 This included a field visit to observe SPU’s encampment trash pilot and a ride along with the SPD South Precinct’s Community Police Team. 17 Public Health - Seattle & King County noted that rodent infestations are a health risk for those individuals who are living unsheltered and also impact neighborhoods and communities as they will be distributed through the neighborhoods when the garbage is cleaned up and when an encampment moves or is removed. Page 19 Review of Navigation Team 2018 Quarter 2 Report A makeshift stove at Dr. Jose Rizal park, and a pile of trash that included an open bucket of human waste awaiting pick-up by SPU’s contractor. Photo credit: Office of City Auditor. These conditions pose serious risks to public health 18 and safety. To address the City’s current risks to public health and safety that can result from thousands of people living unsheltered, our previous two reports19 have called for the City to consider ways to quickly and significantly increase its enhanced shelter capacity. Enhanced shelters provide access to drinking water, heat and electricity, showers, laundry, safe cooking facilities, storage for belongings, and accommodate couples and pets. Enhanced shelters address public health and safety risks created by inadequate access to hygiene facilities, such as those we observed above. In addition, new research shows that homeless individual in shelters have a significantly lower mortality rate than unsheltered individuals. In July 2018, researchers from Boston published a first of its kind longitudinal study of disease experienced by and death of unsheltered homeless individuals. The study tracked 445 unsheltered men in Boston over 10 years and found that their mortality rate was nearly three times greater than a comparison group of men in homeless shelters and almost ten times greater than men in the general population. (Roncarati, et al., 2018) Further, Navigation Team data suggest that its clients are more likely to accept offers of shelter when there is storage for belongings and accommodations for couples and pets. Nonetheless, until the supply of 18 For example, open defecation poses significant risk for disease transmission. Just one gram of fresh feces from an infected person can contain around 1 million viral pathogens and 1-100 million bacterial pathogens. Ending the practice of open defecation by providing adequate sanitation (i.e., the safe disposal of human excreta) is recognized as the most effective means of preventing the transmission of disease through feces. Source: Sanitation and Health, Public Library of Science – Medicine, November 2010. 19 Our first report on the Navigation Team was published in November 2017. Our second report on the Navigation Team was published in October 2018, and it assesses the Executive’s response to 7 of the 14 reporting checkpoints. Page 20 Review of Navigation Team 2018 Quarter 2 Report enhanced shelters catches up with the demand, there are additional steps that the City could take to prioritize hygiene that are described in the following sections. Only six City-funded restrooms are available 24x7 As previously noted, during our field observations, we found significant evidence of open urination and defecation in and around unsanctioned encampments. This poses risks to public health and the environment. Moreover, research has found that open urination and defecation can erode an unsheltered individual’s sense of dignity and self-agency. (Sclar, et al., 2018) (Johnson & Chamberlain, 2008) All but six (See Exhibit 8) City-funded facilities that provide restroom access are closed during the night. Therefore, the unsheltered individuals served by the Navigation Team currently have extremely limited options to avoid open urination and defecation, especially during the night. We identified six City-funded restrooms with daily 24-hour access yearround (i.e., 24x7x365) in 2018. Given that the 2018 point in time count found that, in Seattle, 4,488 people were unsheltered (i.e., they were sleeping in tents, vehicles and RVs, and on the street), the current availability of 24-hour restrooms should be examined. A 2017 audit of public toilets in Los Angeles’ Skid Row applied standards from the United Nations High Commissioner for Refugees (UNHCR). The UNHCR sanitation standards, which are used for operating long-term refugee camps, state that there should be at least one toilet for every twenty persons, and an optimum distance from latrine to household of six to fifty meters. 20 Applying the UNCR sanitation standards to Seattle’s unsheltered population would require proximate access to approximately 224 toilets. Exhibit 8 below also summarizes our observations of health and safety issues at the six sites. The two comfort stations at Green Lake Park had lights, running water, flushing toilets, and were clean and wellmaintained. In contrast, the four portable toilets provided by HSD were poorly-lit and had no running water. Three of the four were damaged in a way that adversely affected their usability (e.g., no toilet seat, no sanitizer dispenser, broken ADA rail). The cleaning log for the portable toilet at the Lake City Mini Park indicated that the unit had not been 20 The UNHCR sanitation standards also indicate that there should be schedules for hygienic maintenance of the sanitation facilities as well as monitoring and reporting on the facilities themselves as well as the paths leading to the sanitation facilities. Page 21 Review of Navigation Team 2018 Quarter 2 Report cleaned for ten days. 21 We observed syringe parts in two of the toilets, and none of the six locations had sharps containers. 22 Several jurisdictions, including Los Angeles, Sacramento, Denver, and Miami, have recently implemented the staffed Mobile Pit Stop model, developed by San Francisco Public Works to address the need for clean safe public restrooms. A profile of the Mobile Pit Stop model is included as Exhibit 9. Further, our office has shared this information and additional details on the costs 23 and implementation of the Mobile Pit Stops with Seattle Public Utilities. 21 HSD’s portable toilet vendor indicated that “missed service dates are the result of individuals who use the toilet as a place to stay/sleep not being willing to vacate the unit so that service can happen.” The vendor noted that keeping toilet paper stocked is a challenge in these units, and that it’s often taken shortly after placement, and lack of hand sanitizer can occur with missed cleanings due to occupants who won’t vacate. The vendor also indicated that they have had challenges with blood spray in these units related to IV drug use. HSD’s 2018 contract with the vendor for provision and maintenance of the four portable toilets is for $50,000. 22 Parks currently has sharps containers in comfort stations at three parks: Dr. José Rizal, Licton Springs, and Westcrest. Parks is tentatively planning to install sharps containers in comfort stations at: Gilman, Cowen, and Othello Park. There are also sharps boxes at four parks (not in the restroom): Fremont Canal Park, Freeway Park, Mineral Springs and Roxhill. 23 San Francisco Public Works provided the following rough cost estimate for the portable Mobile Pit Stop unit: • $73,000 per portable restroom per unit purchase cost (Note: the cost to rent a unit for one year and the cost to purchase a unit are roughly the same. Purchasing a unit is a one-time cost, so the annual cost would go down in years after the unit purchase). • $82,000 per year per unit for nonprofit staffing, materials and supplies, uniform, etc. • $20,000 drivers/fuel, Public Works program management, supplies, doggy bags, needle disposal containers, repair & maintenance of the Public Works-owned portables. • In addition, there was a one-time cost of $193,000 to purchase a vacuum truck to service the portables. Page 22 Review of Navigation Team 2018 Quarter 2 Report Exhibit 8: City-Funded 24x7 Restrooms and Office of City Auditor Observation Summary Location Type District Observed Health/Safety Issues Alaska Junction Portable toilet-HSD-funded 1 • Broken ADA rail • Missing hand sanitizer dispenser • No light inside; Street light only No sharps container Lake City Mini Park Portable toilet-HSD-funded 5 • • • • • • • Green Lake Park – near Wading Pool Green Lake Park – between 64th /65th Ballard Commons Park Seattle Parks comfort station (i.e., restroom with sink, flushing toilet, lights) 6 • No sharps container Seattle Parks comfort station (i.e., restroom with sink and flushing toilet, lights) 6 • No sharps container Portable toilet-HSD-funded 6 • Missing toilet seat and lid • Empty hand sanitizer dispenser • No light inside; Street light and Park light only • No sharps container • Debris in toilet Sacred Heart Shelter Portable toilet-HSD-funded 7 • • • • • Floor completely covered in debris Broken ADA rail Missing hand sanitizer dispenser No light inside; Street light only No sharps container Syringe parts in toilet Feces adjacent on the sidewalk Isolated location No light inside; Street light only No sharps container Syringe parts in toilet Syringe parts adjacent on sidewalk and planting strip The 24x7 restrooms at Green Lake Park have lights and running water and were well maintained (L). We found numerous health and safety issues with the City’s four portable 24x7 toilets; West Seattle Junction (M); Lake City Mini Park (R). Photo credit: Office of City Auditor. Page 23 Review of Navigation Team 2018 Quarter 2 Report Exhibit 9: Profile of San Francisco’s Mobile Pit Stops The Pit Stop Story: “San Francisco Public Works’ Mobile Pit Stop program provides clean and safe public toilets, as well as used-needle receptacles and dog waste stations, in San Francisco's neighborhoods. All the Pit Stop facilities are staffed by paid attendants who help ensure that the bathrooms are well maintained and used for their intended purpose. The units have running water, soap, and hand towels, and are maintained to a standard such that parents and guardians would feel comfortable bringing their children. The program began in San Francisco’s Tenderloin in 2014 at three sites, sparked by a plea from neighborhood middle schoolers who were fed up with having to carefully navigate around human waste on their walk to school. Today, the Pit Stop operates at 25 sites in 12 neighborhoods. Street-cleaning data drives the locations of the Pit Stops, putting them where they’re needed most. Complaints about human waste in public spaces around the Pit Stop locations have gone down, which allows Public Works public cleaning crews to focus more attention on other hotspots. Public Works partners with two nonprofit organizations that staff the Pit Stops, as part of a workforce development program for people who have faced barriers to employment.” – San Francisco Mobile Pit Stop website A standard Mobile Pit Stop (L) and a “Painted Lady” Mobile Pit Stop (R). Photos used with the permission of San Francisco Public Works. "It's private, it's clean, it has a sink, it has soap, it has seat covers, it has paper towels, it has a light. It's wonderful. It's a blessing. It's the way I was raised." - Mischa Fisher, Mobile Pit Stop guest as reported by the LA Times in 2015 Expansion and Replication: San Francisco will add five more Mobile Pit Stops in 2019, bringing the total to 30, and will expand hours at some locations. In addition, the Downtown Miami Association, the City of Denver, the City of Sacramento, and Los Angeles Public Works have adopted the Mobile Pit Stop Model. In 2017, Los Angeles conducted a Mobile Pit Stop pilot program with 8 staffed public toilets. In July 2018, the Los Angeles Mayor and Council approved the extension of the pilot for one year based on the report on the pilot prepared by the Board of Public Works. Click on the image above for a video describing San Francisco’s Mobile Pit Stop Program. Video used with the permission of San Francisco Public Works. Page 24 Review of Navigation Team 2018 Quarter 2 Report Drop-in showers have gaps in geographic coverage and hours of operation Because Navigation Team clients are living on the street in Seattle our review focused on City-funded hygiene services that are available on a drop-in basis, rather than hygiene services that are available only to those living in homeless shelters. We found significant gaps in geographic coverage as well as hours of operation in drop-in shower services. In 2018, the City funded 17 locations (See Exhibit 10 below) where individuals experiencing homelessness can drop in to take a shower. These are facilities that are available for use by individuals who are not registered shelter clients. Given that the Navigation Team serves unsheltered individuals, we focused our analysis on these locations. Exhibit 10: 2018 City Funded Drop-In Shower Facilities by District District 2018 City-Funded Drop-In Shower Facility 1 Delridge Community Center 2 Rainier Community Center Catholic Community Services - Lazarus Center YouthCare - Jackson St. Shelter (Columbia City) 3 Peace for the Streets by Kids from the Streets (PSKS) Compass - Peter's Place Day Center Seattle Indian Center's Community Drop-In Center Miller Community Center 4 Low Income Housing Institute (LIHI) -University District YouthCare - University District 5 No facilities 24 6 LIHI – Ballard Green Lake Community Center 7 YouthCare-Orion Center LIHI – Downtown New Horizons YWCA Compass- Downtown Source: Office of City Auditor analysis of HSD contracts and information provided by Seattle Parks and Recreation Of the 17 locations (see Appendix D), four are Seattle Parks and Recreation Community Centers and 13 are locations run by organizations that have contracts with HSD to provide hygiene services. In terms of geographic distribution, District 5 (North Seattle) had no 24 In 2018, drop-in showers in District 5 were provided without City funding by the Seattle Mennonite Church 12521 33rd Ave NE. Page 25 Review of Navigation Team 2018 Quarter 2 Report City-funded drop-in showers in 2018. 25 District 1 (West Seattle/South Park) has one drop-in shower facility, the Delridge Community Center. Despite its limited hours of operation (4 hours 45 minutes during weekdays),26 Seattle Parks and Recreation reports that the Delridge Community Center provided 3,333 drop-in showers between January 1 and August 31, 2018. The highest concentration of drop-in showers is in District 7 (Downtown/Queen Anne, Magnolia). Exhibit 11: Earliest Drop-In Shower Time for City-Funded Providers by District and Day of the Week, 2018 District Monday Tuesday Wednesday Thursday Friday 1 1pm 1pm 1pm 1pm 1pm 2 7am (ages 50+) 9am (all ages) 7am (ages 50+) 10am (all ages) 7am (ages 50+) 9am (all ages) 7am (ages 50+) 10am (all ages) 7am (ages 50+) 9am (all ages) 3 9am 9am 9am 9am 9am 9am 9am 9am 9am 4 10am (youth/young adults) Saturday Sunday 7am (ages 50+) 9am (all ages) 7am (ages 50+) 10am (youth/young adults) 5 6 6:30am 6:30am 6:30am 6:30am 6:30am 7 5:30am 5:30am 5:30am 5:30am 5:30am 9am 7am (youth/young 7am (youth/young adults) adults) 9am (women) 9am (women) Source: Office of City Auditor (OCA) analysis of HSD contracts; times confirmed through site visits by OCA and HSD staff We noted that there is wide variability in hours of operation of the locations with drop-in showers. Exhibit 11 provides an analysis of the earliest drop-in shower time by district and day. Morning showers are especially important for unsheltered individuals who are going to work or school, seeking employment, or managing certain health conditions. Early morning drop-in showers are currently available for all ages in Districts 6 (Fremont/Ballard) and 7. However, these shower slots are subject to availability, 27 and so individuals may have to wait, return later, or opt not to shower. The City could leverage hygiene as a gateway to other services Our November 2017 report presented an example from Santa Rosa, California where outreach providers use a 16-foot mobile trailer with two bathroom/shower units as an outreach tool to engage unsheltered individuals and connect them with services. We recently interviewed an outreach worker from Santa Rosa’s Homeless Outreach Team who 25 In 2018, drop-in showers in District 5 were provided without City funding by the Seattle Mennonite Church 12521 33rd Ave NE. Posted drop-in hours are: M-F 9am-12pm; Women Only on Tuesdays 12:30pm-4:30pm; up to 14 showers are possible per day. 26 M-Th 1pm-5:45pm (last shower); Fri 1pm-4:45pm (last shower). 27 For example, at LIHI’s Urban Rest Stop in Ballard, individuals seeking a morning shower must arrive and sign up for a slot between 6:30 am and 10 am. The facility then closes from 10:30-11:30 am. So, if you cannot get an early morning shower slot, you can sign up for a time between 11:30am and the last shower of the day at 12:30pm. Page 26 Review of Navigation Team 2018 Quarter 2 Report described how the showers serve as an engagement tool. He indicated that while people are waiting for their showers, the outreach workers build relationships, serve coffee, and help clients fill out paperwork. He explained, “The trust (that the outreach team builds with the showers) makes it easier when the encampment needs to be moved.” There are other jurisdictions that are also leveraging hygiene as a gateway to other services. In Providence, Rhode Island the street outreach team from House of Hope uses a mobile shower as an outreach tool to connect people with services and housing. Their mobile unit is a customized 20’ x 8.3’ trailer that includes: two individual showers with heated floors, an area for case management, and an enclosed private space for medical exams. Mobile laundry vans are deployed in over 20 cities in Australia. The Australian organization, Orange Sky, also brings folding orange chairs and volunteers who engage in non-judgmental conversations with the homeless individuals while they wait for their laundry. The City does not currently use mobile hygiene as part of its outreach strategy. However, HSD has indicated that, “Working with partners who have mobile showers is really valuable.” 28 No consistency in messaging, signage, or standard of care We visited 13 of the City’s 17 drop-in shower locations and all six of the 24x7 restrooms and found considerable variation in the messaging, signage, and standard of care. Some sites had no outside signage that indicated that drop-in showers were available at the facility. Frequently, there were no signs or posters listing the hours that showers are available. In addition, towels and toiletries are not provided at all the shower sites. For example, towel provision varies among four Seattle Parks and Recreation Community Centers: • Delridge – Free towels • Green Lake - $.50 towels • Miller – Free towels • Rainier – No towels At least one HSD provider supplies large paper towels for showers, rather than cloth towels. 28 For example, in 2018, Catholic Community Services (CCS) offered to lend the City the use of its mobile shower. This was initially explored by HSD as a temporary solution to expedite the opening of Lake Union Village. However, HSD determined it was not needed as the planned hygiene trailer for that site was able to be placed for an on-time opening. The City is currently exploring using the CCS mobile shower to support the hygiene needs of individuals living at the Myers Way Village. HSD has instructed the Low Income Housing Institute (LIHI) to work directly with CCS on feasibility and potential timeline and report back by the end of January 2019. Page 27 Review of Navigation Team 2018 Quarter 2 Report It seems essential to provide towels as part of a drop-in shower service for unsheltered individuals. This need was apparent to the staff from the Miller Community Center, who collected towels from family and friends to offer to drop-in shower clients; the towels are laundered on site. Miller staff have also collected a large supply of donated toiletries that they offer to drop-in shower clients. The Miller Community Center reflects a standard of care that could be adopted by all the City’s dropin shower sites. There is currently no consistent signage at any of the City-funded 24x7 restrooms or drop in showers. None of the drop-in shower sites we visited had any posted information from the City that included the contact information for the Navigation Team. Exhibit 14 below provides some examples of the consistent signage used in San Francisco. Consistent signage can provide clear guidelines (e.g., no smoking in the unit, deposit trash in receptacles, etc.) for the use of the facilities as well as important contact information for outreach and services. Other jurisdictions and providers offer features for toilet and shower facilities including: Exhibit 12: Toilet and Shower Features in Other Jurisdictions Features Safe, clean, well-lit toilets, ADA accessible, with soap and water Free use of cloth towels and toiletries for drop-in showers Feminine hygiene supplies available Clean underwear and clothes available if needed Source: See links in table Examples Mobile Pit Stops in: San Francisco, Los Angeles, Sacramento, Denver, Miami Lava Mae (San Francisco, Los Angeles), and many others Lava Mae (San Francisco, Los Angeles); Shower to the People (St. Louis) Lava Mae (San Francisco, Los Angeles), Street Side Showers (Dallas) Exhibit 13: Signage and Standard of Care at City-Funded Drop-In Showers Signage and standard of care varies greatly among City-funded hygiene sites. As shown in the above photo on the left, an HSD-funded facility has no signage outside or inside that identifies it as a hygiene site. Conversely, Parks’ Miller Community Center staff, as seen in the above photo on the right, greet Drop-in shower guests with a stack of freshly laundered towels and a drawer full of donated soaps and shampoos. Photo credit: Office of City Auditor. Page 28 Review of Navigation Team 2018 Quarter 2 Report Exhibit 14: Examples of Consistent Signage from San Francisco These are examples of signage used in San Francisco. On the left is the branding for the Mobile Pit Stops that includes consistent information, with colors and fonts that are customized by neighborhood. The Mobile Pit Stops also provide clear guidelines for their use (e.g., no smoking in the unit, deposit trash in receptacles, etc.). The image on the right is from San Francisco Healthy Streets Operation Center; it is available as a postcard or poster and contains information from the City, including contact information for San Francisco’s Homeless Outreach Team (SFHOT). Photos used with Permission of San Francisco Public Works. Additional steps the City might take to prioritize hygiene Navigation Team clients are affected by the current gaps in the City’s approach to hygiene, including: • Inadequate availability of 24x7 restrooms • Gaps in geographic coverage and hours of operation for drop-in hygiene services • Missed opportunities to leverage hygiene as a gateway to other services • Inconsistent messaging, signage, and standard of care for drop-in hygiene services. In addition to our previous recommendation that the City consider ways to quickly and significantly increase enhanced shelter capacity, there are additional steps the City could take to prioritize hygiene. Page 29 Review of Navigation Team 2018 Quarter 2 Report First, we strongly recommend that the City use data 29 as well as input from unsheltered individuals to help design, implement, evaluate, and refine strategies for addressing gaps in hygiene services. Some examples might include: • The City should consider working with its currently funded Day Centers and Hygiene Centers to explore options for more earlymorning access to toilets and drop-in showers. • The City should consider increasing access to drop-in showers in Seattle Parks and Recreation Community Centers by expanding hours at the four existing sites and/or expanding the number of locations. 30 • The City should reconsider the placement and maintenance of its four existing portable toilets, to ensure that there are minimum standards of safety and cleanliness for these units. • The City should carefully consider the placement of the Mobile Handwashing stations that are included in the 2019 budget, so that these stations are optimally used. • The City might consider testing and evaluating the placement of portable toilets at well-lit locations with 24-hour staff present (e.g., Fire stations). • The City might consider testing and evaluating the Mobile Pit Stop model. Second, we recommend that the City consider strategies to fill gaps in hygiene services that can maximize connections with outreach and other services. Some options include: • The City might consider how mobile shower units could be used by the City as an outreach engagement tool and deployed to underserved geographic areas (e.g., early morning showers in Delridge, evening showers in SODO, etc.). • To help address the issue of high concentrations of open defecation at Jose Rizal Park, the City might consider having Cityfunded outreach staff “host” the Park’s comfort station overnight, so it remains open for safe use. This would also provide another opportunity for outreach workers to build relationships and make connections to services. 29 In addition to the drop-in shower usage data that is already collected by Parks and HSD, the City might consider collecting: numbers of individuals turned away from drop-in showers due to capacity, feedback from drop-in shower users on hours and locations, feedback from drop-in shower users on availability of 24x7x365 restrooms, etc. 30 In addition to the four Seattle Parks’ Community Centers that currently provide drop-in shower services, we identified six additional Community Centers (CC) that have showers that are currently restricted for use by program participants/facility users/Parks’ staff: Alki CC, Bitter Lake CC, Loyal Heights CC, Meadowbrook CC, Montlake CC, and Northgate CC. Page 30 Review of Navigation Team 2018 Quarter 2 Report Third, we recommend that the City establish a standard of care for all its drop-in hygiene sites (e.g., provision of towels and toiletries, clearly posted hours for drop-in services, etc.). Finally, we recommend that the City consider developing consistent signage or posters for all its drop-in hygiene sites that provides important information for unsheltered individuals, including contact information for City homeless outreach. Recommendations The table below lists our recommendations for Checkpoint 2.2: Assessment of opportunities for prioritizing hygiene. Checkpoint # 2.2 Assessment of opportunities for prioritizing hygiene Recommendation A. Since enhanced shelters have 24x7 restrooms, showers, and laundry, the City should consider ways to quickly and significantly increase enhanced shelter capacity as a means of prioritizing hygiene. B. The City should use data as well as input from unsheltered individuals to help design, implement, evaluate, and refine strategies for addressing gaps in hygiene services. (See examples above.) C. The City should consider strategies to fill gaps in hygiene services that can maximize connections with outreach and other services. (See examples above.) D. The City should establish a standard of care for all its 24x7 toilets and drop-in shower sites (e.g., provision of towels and toiletries and clearly posted hours for drop-in services). E. The City should consider developing consistent signage or posters for all its drop-in hygiene sites that provides important information for unsheltered individuals, including contact information for City homeless outreach. Page 31 Review of Navigation Team 2018 Quarter 2 Report CHECKPOINT 3.5: DEVELOPMENT OF A STRONGER EVALUATION PLAN AND CHECKPOINT 3.6: PLAN FOR UNSHELTERED INDIVIDUALS TO BE MEANINGFULLY ENGAGED IN THE NAVIGATION TEAM EVALUATION “Unless social programs are evaluated for potential harm as well as benefit, safety as well as efficacy, the choice of which social programs to use will remain a dangerous guess.” – Joan McCord, Temple University from Cures that Harm: Unanticipated Outcomes of Crime Prevention Programs, Annals of the American Academy of Political and Social Science, 2003 Section Summary Our 2017 Reporting Plan for the Navigation Team included recommendations for the City to better use data and evaluation to ensure that it achieves its intended outcomes. Reporting Checkpoints 3.5 and 3.6 raised questions about how the City might strengthen its evaluation of the Navigation Team and how unsheltered individuals might be meaningfully involved in ongoing evaluation of the Navigation Team. The Executive’s Quarter 2 Response indicated that data and evaluation support for the Navigation Team transitioned to HSD as of July 2018, and that: • A revised Theory of Change for the Navigation Team will be available by fall of 2018; • Baseline data collection will begin in January 2019; and • HSD is “making strategic plans to include the voices of those who have experienced or are currently experiencing homelessness.” However, the Executive’s Quarter 2 Response did not indicate that the Executive would be pursuing an independent rigorous evaluation. We recommend that the Executive provide an update on its progress with its data and evaluation efforts and that the Executive and City Council re-consider the City’s options for independent rigorous evaluation. Page 32 Review of Navigation Team 2018 Quarter 2 Report Rigorous independent evaluation can ensure that the City’s strategies achieve their intended outcomes and do not unintentionally cause harm Our 2017 report described possible low-cost and no-cost opportunities for rigorous independent evaluation for the City including: • Working with the existing evaluation unit in Public Health - Seattle & King County; • Obtaining free evaluation technical assistance from federal agencies; • Partnering with local universities on field research studies conducted by graduate students; and • Working with the Washington State Institute for Public Policy which has a well-established methodology for benefit-cost calculations. The Executive’s Quarter 2 Response concluded that, “many of the rigorous academic evaluation options suggested by the City Auditor would incur a high cost and are only utilized after a program has been through a few years of practice.” 31 Our 2017 report described possible low-cost and no-cost opportunities for rigorous independent evaluation for the City. Public Health-Seattle & King County has also offered to provide the Executive with a range of options for rigorous independent evaluation. The Executive’s resistance to pursuing rigorous independent evaluation, even at no-cost or low-cost to the City, is concerning. As noted above by the criminologist Joan McCord, 32 without rigorous evaluation, the City’s approach to addressing unsheltered homelessness remains “a dangerous guess.” Our 2017 report raised questions about the potential for unintended consequences as a result of the City’s current approaches. These include the potential public health and safety consequences from a lack of adequate sanitation and hygiene strategies and potential traumatic exposure for unsheltered individuals from the use of police in an outreach capacity. 31 It is incorrect to say that rigorous independent evaluations are “only utilized after a program has been through a few years of practice.” In fact, our October 2018 report described the evaluation of Seattle’s Law Enforcement Assisted Diversion (LEAD) program, which had included an evaluation component as part of the initial program design. This allowed the evaluation team to collect data in the first few years of the LEAD implementation (October 2011 through January 2014). Consequently, the LEAD evaluation demonstrated program success and has informed program refinement in recent years. In addition, our November 2017 report included information about empowerment evaluation which is conducted by the organization itself, with coaching and technical assistance from an evaluator(s), who ensures the rigor of the evaluation but does not control the evaluation. The ten principles of empowerment evaluation include: improvement, community ownership, inclusion, democratic participation, social justice, community knowledge, evidence-based strategies, capacity building, organizational learning, and accountability. (Fetterman, Kafterian, & Wandersman, 2015) 32 The late criminologist Joan McCord wrote about popular programs that had been scientifically debunked, such as D.A.R.E. and Scared Straight, finding that they ultimately caused more harm than good for the people they were intended to serve. Page 33 Review of Navigation Team 2018 Quarter 2 Report It is important to ensure that unsheltered individuals are meaningfully involved in the evaluation of the Navigation Team Rigorous independent evaluation can help ensure that the City’s efforts are achieving their intended outcomes and do not unintentionally cause harm. Further, our 2017 report offered a number of suggestions for meaningfully engaging the people served by the Navigation Team in the City’s evaluation efforts. HSD has an opportunity to leverage the Racial Equity Toolkit (RET) work that it is already doing to engage unsheltered individuals in a rigorous evaluation of the Navigation Team. HSD indicated that it has begun the development of a RET that will inform future Navigation Team planning. Draft outcome measures have been proposed and will be reviewed and revised during public comment in early 2019. HSD indicated that the RET process will engage a broad group of stakeholders, including:          Unhoused individuals, including those needs associated with health, mental health, chemical dependency, and criminal justice system issues. City department staff Outreach providers Mental health professionals Neighborhoods groups Businesses representatives Organizations that are impacted by the Navigation Team’s work Activist community representatives Faith-based organizations Based on the Executive’s Quarter 2 Response to Checkpoints 3.5 and 3.6, we recommend that the Executive provide an update on its progress with its data and evaluation efforts and that the Executive and City Council re-consider the City’s options for rigorous independent evaluation of the City’s Navigation Team approach. Recommendations Checkpoint # 3.5: Development of a stronger evaluation plan 3.6 Plan for unsheltered individuals to be meaningfully involved in the Navigation Team evaluation The table below lists our recommendations for Checkpoint 3.5: Development of a stronger evaluation plan and Checkpoint 3.6 Plan for unsheltered individuals to be meaningfully involved in the Navigation Team evaluation. Recommendation A. The Executive should provide an update on its progress with its data and evaluation efforts described in the Executive’s Quarter 2 Response. B. The Executive and City Council should re-consider the City’s options for independent rigorous evaluation of the City’s Navigation Team approach. A. The Executive should provide an update on its progress with its efforts to meaningfully involve unsheltered individuals in the evaluation of the Navigation Team as described in the Executive’s Quarter 2 Response. Page 34 Review of Navigation Team 2018 Quarter 2 Report OBJECTIVES, SCOPE, AND METHODOLOGY Audit Scope and Methodology This audit was conducted at the request of Councilmember Lisa Herbold for our office to assess the Executive’s Quarter 2 response to the Navigation Team reporting plan which responded to 5 of the 14 reporting checkpoints from the Office of City Auditor’s 2017 report, Reporting Plan for Navigation Team. We conducted this audit using various methodologies, as follows: • We reviewed the Executive’s August 10, 2018 Quarter 2 Response to SLI 242-1-A-1; • We interviewed officials from several City departments: Human Services Department, Parks and Recreation, Office of Emergency Management, Police, as well King County; • We made site visits to hygiene centers and Parks comfort stations, and verified days/hours of operations for many of them; • We made site visits to locations for the SPU encampment trash pilot program; • We analyzed the City’s capacity and geographic reach of its 2018 outreach providers; • We researched the processes of how the City is notified of new encampments; • We researched emergency management field operations best practices and how the City is employing those best practices; • We researched how the City is responding to address the needs of the newly homeless; • We researched examples of early outreach programs from other jurisdictions; • We researched the Navigation Team’s access to outreach and diversion funds; • We researched free/low-cost evaluation options for consideration by the Navigation Team. Per our standard practice, we conducted a process based on the City’s Racial Equity Toolkit for our work on this report. Further, we intentionally sought opportunities to incorporate into our analysis the experience of people living unsheltered. This included our fieldwork to confirm the locations and conditions of drop-in showers and 24x7 restrooms. We are also grateful to Dr. Karen Snedker of Seattle Pacific University who provided us with excerpts from interviews with residents of Tent City Three that addressed issues related to hygiene and stigmatization. It was also important to us to learn about the experience of HSD’s outreach and hygiene providers. We read all the quarterly narrative Page 35 Review of Navigation Team 2018 Quarter 2 Report reports for 2018 provided by the contracted providers, and we read all the materials produced in 2018 by the Outreach Continuum. These reports provided detailed and useful information about the operations, challenges, and successes of the HSD-contracted organizations. We conducted this performance audit in accordance with generally accepted government auditing standards. Those standards require that we plan and perform the audit to obtain sufficient appropriate evidence to provide a reasonable bass for our finding and conclusions based on our audit objectives. We believe that the evidence obtained provides a reasonable basis for our finding and conclusions based on our audit objectives. Page 36 Review of Navigation Team 2018 Quarter 2 Report APPENDIX A References and Hyperlinks References Fetterman, D. M., Kafterian, S. J., & Wandersman, A. (2015). Empowerment Evaluation: Knowledge and Tools for Self- Assessment, Evaluation Capacity-Building, and Accountability. Los Angeles, CA: Sage. Johnson, G., & Chamberlain, C. (2008). From Youth to Adult Homelessness. Australian Journal of Social Issues, 4: 563-582. Roncarati, J., Baggett, T., O'Connell, J., Hwang, S., Cook, E., Kreiger, N., & Sorenson, G. (2018). Mortality Among Unsheltered Homeless Adults in Boston, Massachusetts, 2000-2009. JAMA Internal Medicine, Sep 1;178(9):1242-1248. Sclar, G., Penakalpati, G., Caruso, B., Rehfuess, E., Garn, J., Alexander, K., . . . Clasen, T. (2018). Exploring the relationship between sanitation and mental and social well-being: A systematic review and qualitative analysis. Social Science and Medicine, 217: 121-134. Hyperlinks Websites that are referenced multiple times are listed only on the page on which they first occur. Page Website Name / Description Website Address 1 Quarter 2 Response to Navigation Team Reporting Plan Reporting Plan for Navigation Team, Office of City Auditor, November 2017 Regional Approach to Addressing Homelessness Report by Future Laboratories to the City of Seattle and King County 2018 Point in Time Count Seattle/King County Point in Time Count for Persons Experiencing Homelessness, 2018 Review of Navigation Team 2018 Quarter 1 Response, Office of City Auditor, October 2018 The State of Homelessness Beyond Seattle: Mandy Chapman Semple and Phil Ansell, March 27, 2017 http://seattle.legistar.com/View.ashx?M=F&ID=6439383&GUID= 3C355BD3-34F0-4F6F-81E2-317378AEEFE6 http://www.seattle.gov/Documents/Departments/CityAuditor/au ditreports/NavigationTeamReportingPlan110717.pdf 1 1 1 2 2 3 4 https://kingcounty.gov/elected/executive/constantine/news/rele ase/2018/December/19-governance-homeless.aspx https://hrs.kc.future.com/ http://allhomekc.org/king-county-point-in-time-pit-count/ http://allhomekc.org/wpcontent/uploads/2018/05/FINALDRAFTCOUNTUSIN2018REPORT-5.25.18.pdf http://www.seattle.gov/Documents/Departments/CityAuditor/au ditreports/Review%20of%20Navigation%20Team%202018%20Q uarter%201%20Report_10-2-18.pdf https://www.youtube.com/watch?v=T5nU_tjRgAU Page 37 Review of Navigation Team 2018 Quarter 2 Report 4 4 5 8 8 8 10 11 11 11 12 12 12 14 14 15 15 15 16 18 20 New York City’s Homeless Outreach and Mobile Engagement Street Action Teams (HOME-STAT) London’s No Second Night Out Program Hepatitis Education Project Seattle’s Union Gospel Mission Search and Rescue Metropolitan Improvement District (MID) Homeless Outreach Team Full Life Care Human Services Department 2018 Outreach and Engagement contract for LEAD FEMA’s Incident Command System (ICS) FEMA’s Emergency Management Institute Incident Command Center (ICS) Overview Healthy Street Operation Center (KSOC) Homeless Outreach Snohomish County’s MultiAgency Coordination Group Snohomish County’s Consolidated Action Plan Los Angeles Homeless Services Authority (LAHSA) LA-HOP Seattle Find-It Fix-It App and Customer Service Bureau (CSB) StreetLink Los Angeles Homeless Outreach Portal Mary’s Place Outreach Request Portal Downtown San Diego Partnership Report of the Special Rapporteur on adequate housing as a component of the right to an adequate standard of living, and on the right to non-discrimination in this context, September 19, 2018 Mortality Among Unsheltered Homeless Adults in Boston, Massachusetts, 2000-2009 https://www1.nyc.gov/site/operations/projects/HomeStat.page http://www.nosecondnightout.org.uk/about-nsno/latest-facts/ http://www.hepeducation.org/ https://www.ugm.org/what-we-do/search-rescue/ https://downtownseattle.org/programs-and-services/downtownambassadors/outreach-team/ https://www.fulllifecare.org/ http://www.seattle.gov/Documents/Departments/CityAuditor/au ditreports/LEADOutreach.pdf https://www.fema.gov/incident-command-system-resources https://training.fema.gov/emiweb/is/icsresource/index.htm https://training.fema.gov/emiweb/is/icsresource/assets/reviewm aterials.pdf http://sanfranciscopolice.org/sites/default/files/Documents/Polic eCommission/PoliceCommission090518-HSOCPresentation.pdf https://snohomishoverdoseprevention.com/welcome/opioidmac-group/ https://www.findingfixes.com/s/6z71ji2sbdovcqxsmfuux44ayjsyg y https://www.lahsa.org/portal/apps/la-hop/request http://www.seattle.gov/customer-service-bureau/contact-us https://www.streetlink.org.uk/ https://www.lacounty.gov/lahop/ https://www.marysplaceseattle.org/outreach-request https://downtownsandiego.org/clean-and-safe/ https://www.ohchr.org/en/issues/housing/pages/annualreports.a spx (Select A/73/310/Rev.1) https://www.ncbi.nlm.nih.gov/pubmed/30073282 Page 38 Review of Navigation Team 2018 Quarter 2 Report 20 21 21 24 24 24 24 26 27 27 28 28 28 29 32 33 33 33 33 Sanitation and Health, Public Library of Science – Medicine, November 2010 No Place to Go An Audit of the Public Toilet Crisis in Skid Row Guidance for UNHCR Filed Operations on Water and Sanitation Services San Francisco Public Works’ Mobile Pit Stop Program NPR Story on San Francisco’s Mobile Pit Stop Program Curbed Story on Los Angeles’s Pilot Mobile Pit Stop Program Report on Los Angeles’s Pilot Mobile Pit Stop Program Homeless Outreach Services Team (HOST) Clean Start Mobile Bathroom-Shower Schedule House of Hope Mobile Shower Orange Sky Mobile Showers Lava Mae Mobile Showers Shower to the People Mobile Showers Streetside Showers San Francisco Homeless Outreach Team (SFHOT) Cures that Harm: Unanticipated Outcomes of Crime Prevention Programs, Annals of the American Academy of Political and Social Science, 2003 Washington State Institute for Public Policy Benefit-Cost Analysis Methodology LEAD Program Evaluation Joan McCord Obituary, New York Times, March 2004 Center for Evidence-Based Crime Policy - DARE https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2981586/pdf/pm ed.1000363.pdf http://www.innercitylaw.org/wp-content/uploads/2017/07/NoPlace-To-Go-final.pdf https://www.unhcr.org/49d080df2.pdf https://sfpublicworks.wixsite.com/pitstop https://www.npr.org/sections/thetwoway/2017/11/22/566031917/just-look-at-these-fancy-port-apotties?utm_campaign=storyshare&utm_source=twitter.com&ut m_medium=social https://la.curbed.com/2018/7/23/17595360/homeless-publicbathrooms-mobile-pit-stop-program http://boe.lacity.org/docs/dpw/agendas/2018/201807/20180723 /bd/20180723_ag_br_bpw_1.pdf https://srcity.org/DocumentCenter/View/6328/Clean-StartSchedule-PDF?bidId= https://thehouseofhopecdc.org/shower-to-empower/ https://orangesky.org.au/where-we-are/ https://www.youtube.com/watch?v=5J8xeEkADCM https://www.youtube.com/watch?v=d5dVPXPQPQ8 https://www.youtube.com/watch?v=oFPQvomrGRQ http://hsh.sfgov.org/street-homelessness/homeless-outreachteam/ https://www.ncjrs.gov/App/Publications/abstract.aspx?ID=23610 1 http://www.wsipp.wa.gov/BenefitCost http://static1.1.sqspcdn.com/static/f/1185392/27047605/146438 9327667/housing_employment_evaluation_final.PDF?token=tPIV 8jGCy6%2F25AsphFKADLw7yek%3D https://www.nytimes.com/2004/03/01/nyregion/joan-mccordwho-evaluated-anticrime-efforts-dies-at-73.html https://cebcp.org/evidence-based-policing/what-works-inpolicing/research-evidence-review/drug-abuse-resistanceeducation-d-a-r-e/ Page 39 Review of Navigation Team 2018 Quarter 2 Report 33 35 Scared Straight and Other Juvenile Awareness Programs for Preventing Juvenile Delinquency: A Systematic Review City of Seattle’s Racial Equity Toolkit http://www.campbellcollaboration.org/media/k2/attachments/Pe trosino_Scared_Straight_Update.pdf http://www.seattle.gov/civilrights/programs/race-and-socialjustice-initiative/racial-equity-toolkit Page 40 Review of Navigation Team 2018 Quarter 2 Report APPENDIX B List of Recommendations Checkpoint # 2.1 Assessment of opportunities for early outreach intervention Recommendation A. The City should consider implementing frequent systematic tactical communication among outreach providers. B. The City should use a robust systematic approach for managing homeless outreach field operations and should consider reinstating elements of the ICS framework to help ensure effective management of homeless outreach field operations. C. The City should consider improving its capacity for receiving reports of newly unsheltered individuals and quickly dispatching outreach. D. The City should consider increasing access to and use of diversion strategies for all City-funded homeless outreach (i.e., Navigation Team and other City-funded homeless outreach providers) to serve newly unsheltered individuals. E. The Executive should provide the Office of City Auditor with a status report on the implementation of the planned “enhancements” described in the Quarter 2 response: a. Enhance data collection practices to create a history and duration of homelessness for all individuals encountered in the field. b. Increase opportunities for shared resources such as diversion and rapid re-housing assistance to increase resources and the speed with which people are transitioned to more stable housing options. c. Increase skills and training for outreach staff to provide robust and trauma-informed mental health and substance use disorder services. d. Increase partnerships with community-based organizations that provide employment training, education and culturally-based support services to improve client outcomes for housing retention. e. Increase skillset of the Navigation team to include stronger relationships with individuals with lived experience as peer supports. 2.2 Assessment of opportunities for prioritizing hygiene A. Since enhanced shelters have 24x7 restrooms, showers, and laundry, the City should consider ways to quickly and significantly increase enhanced shelter capacity as a means of prioritizing hygiene. Page 41 Review of Navigation Team 2018 Quarter 2 Report 3.5: Development of a stronger evaluation plan B. The City should use data as well as input from unsheltered individuals to help design, implement, evaluate, and refine strategies for addressing gaps in hygiene services. (See examples above.) C. The City should consider strategies to fill gaps in hygiene services that can maximize connections with outreach and other services. (See examples above.) D. The City should establish a standard of care for all its 24x7 toilets and drop-in shower sites (e.g., provision of towels and toiletries and clearly posted hours for drop-in services). E. The City should consider developing consistent signage or posters for all its drop-in hygiene sites that provides important information for unsheltered individuals, including contact information for City homeless outreach. A. The Executive should provide an update on its progress with its data and evaluation efforts described in the Executive’s Quarter 2 Response. B. The Executive and City Council should re-consider the City’s options for independent rigorous evaluation of the City’s Navigation Team approach. 3.6 Plan for unsheltered individuals to be meaningfully involved in the Navigation Team evaluation A. The Executive should provide an update on its progress with its efforts to meaningfully involve unsheltered individuals in the evaluation of the Navigation Team as described in the Executive’s Quarter 2 Response. Page 42 Review of Navigation Team 2018 Quarter 2 Report APPENDIX C Staffing Detail for HSD’s Contracted Outreach and Engagement Provider s Agency YouthCare 2018 HSD-Funded Staff and Full-Time Equivalent Amounts Program Manager Housing Navigator Housing Navigator Director Orion Case Manager Supervisor Housing Navigator Housing Navigator Case Management Supervisor Outreach Supervisor Outreach Case Manager Outreach Worker Orion Case Manager .10 1.00 1.00 0.05 .10 2018 Non-City Funded Staff and Full-Time Equivalent Amounts Case Management Supervisor Outreach Supervisor Outreach Case Manager Outreach Worker Orion Case Manager 0.5 1.0 1.25 0.25 Co-Director Supervisor IT Support Data Specialist Finance Specialist Admin Assistant Office Manager Case Manager Outreach Coordinator .34 0.68 0.12 0.17 0.12 0.25 0.34 5.44 1.02 0.75 1.00 1.00 0.25 0.5 1.0 1.0 0.75 Seattle Indian Center Lead Outreach Worker Outreach Worker 1.0 1.0 Public Defender Association – LEAD Co-Director Supervisor IT Support Data Specialist Finance Specialist Admin Assistant Office Manager Case Manager Outreach Coordinator 0.66 1.32 0.23 0.33 0.23 0.5 0.66 10.56 1.98 Downtown Emergency Service Center – HOST Supervisor Program Coordinator Case Managers 1.0 1.0 2.4 Evergreen Treatment Services – REACH (Navigation Team) Outreach Case Manager Outreach Supervisor Assessor/Navigator IT & Data Support Finance Specialist Co-Directors Data Quality 7.0 1.0 0.25 0.10 0.10 0.40 0.20 Homeless Outreach Stabilization and Transition (HOST) is an interdisciplinary team of 16 mental health, chemical dependency and medical professionals. HOST staff provide outreach, engagement, and transitional support services to severely mentally ill homeless persons. Page 43 Review of Navigation Team 2018 Quarter 2 Report Mary’s Place Housing Services Director Diversion Manager Diversion Specialist Accounting Assistant 0.13 0.13 0.50 0.00 Seattle Indian Health Board Outreach Worker (CSC) Outreach Worker (MN) Outreach Worker (SIHB) Program Director (CSC) Program Director (MN) Executive Director (CSC) Executive Director (MN) Accountant (SIHB) HMIS Data Compliance Coordinator Accounts Payable Specialist Housing Locator (SIHB) 1.0 1.0 1.0 0.12 0.22 0.03 0.02 0.34 Housing Director Outreach Team Member Case Manager/ Intake .05 2.0 .50 Urban League Housing Services Director Diversion Manager Diversion Specialist Accounting Assistant 0.25 0.25 3.50 0.75 0.34 0.34 0.17 Page 44 Review of Navigation Team 2018 Quarter 2 Report APPENDIX D Drop-In Showers Exhibit 15: Map of Drop-In Shower Facilities, 2018 Source: Office of City Auditor analysis of HSD contracts and information provided by Seattle Parks and Recreation Page 45 Review of Navigation Team 2018 Quarter 2 Report Exhibit 16: Drop-In Shower Facilities Address 4501 Delridge Way SW 98106 4600 38th Ave S 98144 2329 Rainier Avenue South 3722 S Hudson St. 1609-19th Ave Drop-In Shower Facility Name Delridge Community Center Rainier Community Center Catholic Community Services Lazarus Center Youth Care – Jackson St. Shelter (Columbia City) PSKS 901 Rainier Ave S Compass Peter's Place Day Center 1265 S. Main St. #105 98144 Seattle Indian Center's Community Drop-In Center Miller Community Center LIHI -U District 330 19th Ave E 98112 Urban Rest Stop University District 1415 NE 43rd 98105 University District Youth Center 451615th Ave NE 98105 Urban Rest Stop 2014 NW 57th St 98107 YouthCare - U District LIHI - Ballard M-Th 1pm-5:45pm (last shower); Fri 1pm-4:45pm (last shower) 1 Population Focus per HSD Q2 response All M, W: 9am-9pm (8:45 pm last shower); Tu, Th: 10am-9pm (8:45 pm last shower); Fri 9am-6pm (5:45pm last shower); Sat: 9am-5pm (4:45pm last shower); Sun: closed; M-F 7am to 6pm 2 All 2 Adults over the age of 50 M-F 10-1 TWTh 3:30-6:30 Weekends – no drop-in services 2 Youth/Young Adults MTWF: noon-3pm (2:15pm last shower), no drop-in showers on weekends, but shelter is currently all on a drop-in basis, shelter is open 7 days/wk 9:30pm-7:30am and ok to take showers anytime during shelter hours. M-F 9am-noon 3 Single Males/Females, Couples, Families, Youth/Young Adults 3 Single Males/Females, Couples, Young Adults M-F 10am-3:30pm 3 MWF noon-8pm; Tu/Th 9am-5pm 3 All This location was closed on Tuesday 9/4 when we visited because of Labor Day. Their website lists hours as Tu-Th 9-11:30, 1-5:30; F 9-11:30, 1-5. M, W, Th, Su 10am-2pm; Tu 10am3pm; F-Sa closed 4 Single Males/Females, Couples, Families, Youth/Young Adults 4 Youth/Young Adults Monday-Friday 6:30-2:30; Closed daily 10:30-11:30; last shower 12:30 6 Single Males/Females, Couples, Families, Youth/Young Adults Office of City Auditor Observed Hours for Drop-In Showers District Page 46 Review of Navigation Team 2018 Quarter 2 Report 7201 East Green Lake Dr N 98115 1828 Yale Avenue Green Lake Community Center YouthCareOrion Center M-F 10am-8pm, Sat 9am-4:30pm; Sunday Closed 6 All Showers avail for use anytime Center is open: M, W, Th F 9:00am6pm (last shower 5:30pm), closed Sundays, Sat 11am-1:00 pm (last shower 12:30pm) M-F 5:30am-6pm, staff did not know if weekend hours avail 7 Youth/Young Adults 7 Cannot use services if housed; Single Males/Females, Couples, Families, Youth/Young Adults Youth/Young Adults Urban Rest Stop Downtown 19249th Ave 98101 LIHI - Downtown New Horizons Ministries 2709 3rd Avenue Angeline's Day and Shelter Services 2030 Third Avenue New Horizons As of Nov 16th, will be open from 7 am-9 pm, 7 days per week. 7 YWCA 7 Single Females, Young Adults 77 South Washington St CompassDowntown 9 am the women can sign up for shower slot, 30 min per person per shower. 9 am-4 pm for day showers. 7 pm-8 pm for evening showers. 3 working showers 7 am-12:30 pm. Groups of 6. Come in as early as possible to get a spot, opening at 7 am. 7 Single Males/Females, Couples, Young Adults Source: Auditor analysis of Human Services Department contracts Exhibit 17: Parks Shower Program Usage January 1August 31, 2018 Monthly Average Daily Average Miller 440 55 3 Rainier 230 29 1 3,333 417 20 Delridge Green Lake Not possible to collect* *Green Lakes showers are accessible through an external door and access is not monitored. Source: Auditor analysis of Seattle Parks and Recreation data Page 47 Review of Navigation Team 2018 Quarter 2 Report APPENDIX E Letter from the Public Defender Association Page 48 Review of Navigation Team 2018 Quarter 2 Report homeless, but to run and staff a justice system diversion program that reduces crime through intensive case management and justice system coordination, and to do community engagement in service ofthat paradigm shift (the City doesn?t so far fund the latter, by the way that work is supported by King County funding at present). I anticipate you will be asked to discuss this report with Council and other policymakers going forward, so wanted to flag this important distinction before those conversations go further. I?d welcome a conversation if you think that would be useful. Yours, Lisa Da ugaa rd Director CC: Tara Moss/Seattle-Klng County LEAD Program Director Tess Colby/Mayo r?s Office Greg Doss/City Council Central Staff Alan Lee/City Council Central Staff Tiffany Washington/H50 Jason Johnson/HSD Tanya Claudia Gross-Shader/City Auditor Robin Howe/City Auditor Councilmember Lisa Herbold Page 49 Review of Navigation Team 2018 Quarter 2 Report APPENDIX F Seattle Office of City Auditor Mission, Background, and Quality Assurance Our Mission: To help the City of Seattle achieve honest, efficient management and full accountability throughout City government. We serve the public interest by providing the City Council, Mayor and City department heads with accurate information, unbiased analysis, and objective recommendations on how best to use public resources in support of the well-being of Seattle residents. Background: Seattle voters established our office by a 1991 amendment to the City Charter. The office is an independent department within the legislative branch of City government. The City Auditor reports to the City Council and has a four-year term to ensure her/his independence in deciding what work the office should perform and reporting the results of this work. The Office of City Auditor conducts performance audits and non-audit projects covering City of Seattle programs, departments, grants, and contracts. The City Auditor’s goal is to ensure that the City of Seattle is run as effectively, efficiently, and equitably as possible in compliance with applicable laws and regulations. How We Ensure Quality: The office’s work is performed in accordance with the Government Auditing Standards issued by the Comptroller General of the United States. These standards provide guidelines for audit planning, fieldwork, quality control systems, staff training, and reporting of results. In addition, the standards require that external auditors periodically review our office’s policies, procedures, and activities to ensure that we adhere to these professional standards. Seattle Office of City Auditor 700 Fifth Avenue, Suite 2410 Seattle WA 98124-4729 Ph: 206-233-3801 www.seattle.gov/cityauditor Page 50